What do I need to do to lower my cholesterol?

DEAR DOCTOR K:

My cholesterol has always been fine, but recently it’s started to rise, though not high enough for medication. What do I need to do?

DEAR READER:

There are several ways you can lower your cholesterol besides taking medicine. They involve cholesterol-friendly lifestyle changes: dietary modifications and regular exercise.

Start with your diet. First, let’s consider fats. The types of fat you eat are as important as the amounts you eat. Most animal and dairy fats are full of unhealthy saturated fats, which raise cholesterol levels.

In fact, consuming foods with saturated fat will raise your blood levels of cholesterol more than consuming foods high in cholesterol itself (interestingly, cholesterol is also a type of fat). Saturated fats stimulate your liver to produce more cholesterol, and your liver is the main source of cholesterol in your body.

Saturated fats are found mostly in animal products, such as meat, milk and eggs. A few vegetable oils, such as palm oil, coconut oil and cocoa butter, also contain saturated fats.

Trans fats are even worse and should be avoided completely. Trans fats raise LDL (bad) cholesterol and lower HDL (good) cholesterol. It’s a double whammy. Trans fats can be found in hard (stick) margarines and processed cakes, biscuits, cookies and a range of other products. The FDA is likely to ban trans fats in the near future.

On the other hand, most vegetable fats (oils) are made up of unsaturated (polyunsaturated and monounsaturated) fats that are healthy for your heart. You can find these healthier fats in fish as well as nuts, seeds, vegetables and most vegetable oils. Opt for these whenever possible. They don’t raise your blood cholesterol levels.

Two more dietary changes can also help. First, increase your intake of soluble dietary fiber. Oat bran, barley, nuts, seeds, beans and lentils are all good sources. Second, increase your consumption of plant sterols and stanols. These naturally occurring plant compounds limit the amount of cholesterol your body can absorb. You can find sterol- and stanol-enriched orange juice, cereals and margarine spreads in the grocery store.

The other key lifestyle change is regular exercise, which improves cholesterol levels and protects against cardiovascular disease. It also raises HDL (good) cholesterol.

Aim for at least 30 minutes of moderate-intensity physical activity on most days of the week. Find an activity, or combination of activities, that you enjoy — and stick with it. Jogging, running, swimming, biking, tennis and basketball are all great options.

Continue to maintain these lifestyle changes even if you eventually need medication.

It sounds like you’d prefer not to take cholesterol medicines, but there’s some new information you should know. The statins, medicines that lower cholesterol, have been discovered to protect against heart disease even in people with normal cholesterol levels. For that reason, statins are recommended in people with several risk factors for heart disease — even if their cholesterol levels are normal.

So while you absolutely should consider lifestyle changes first to lower your cholesterol, check with your doctor about whether you might also benefit from statins.

Related Information: Harvard Heart Letter